The role of religiosity and religious participation in the relationship between depressive symptoms and cognitive impairment among older Indian adults

Abstract

Due to different nature of social engagements of older adults in South Asian countries specially attributed to the traditional family-based care and support, beneficial effects of religiosity and religious involvement on mental health and cognitive function in older age might be different than those in the Western world. Yet, there is a paucity of research in these countries on the role of religion in moderating the relationship between late life depression and cognition. This study explored the association of depressive symptoms with cognitive impairment and the moderating effects of religiosity and religious participation in those associations among older Indian adults. A cross-sectional study was conducted on data that were drawn from the Longitudinal Ageing Study in India wave-1, collected during 2017–2018. The sample size comprised of 31,464 older adults aged 60 years and above. Shortened 10-item Centre for Epidemiologic Studies Depression Scale was used to measure depressive symptoms. Items from the Mini-Mental State Examination and the cognitive module of the China Health and Retirement Longitudinal Study and the Mexican Health and Aging Study were adapted for measuring cognitive impairment. Moderated multiple linear regression models were used to test the research hypotheses of the study. The proportion of older adults who reported religion as less important to them was 21.24%, whereas, only 19.31% of the respondents participated in religious activities. The mean score of cognitive impairment (on a scale of 0–43) in the current sample was 19.43 [confidence interval (CI): 19.32–19.53] among men and 23.55 [CI: 23.44–23.66] among women. Older adults with depressive symptoms had significantly higher likelihood of cognitive impairment [aCoef: 0.18, CI: 0.16–0.20] in comparison to older adults with no depressive symptoms. Older individuals who were religious were significantly less likely to have cognitive impairment [aCoef: − 0.43, CI: − 0.61 to − 0.25] than their non-religious counterparts. Compared to older adults who did not participate in religious activities, those who participated in religious activities were less likely [aCoef: − 0.52, CI: − 0.69 to − 0.34] to have cognitive impairment. Further, significant moderating effects of religiosity and religious participation in the relationship between depressive symptoms and cognitive impairment were observed. The current study contributes to advancing knowledge about the mental health benefits of religiosity and religious participation by focusing on older adults in India who culturally have limited chances to participate in social activities. The findings suggest that older adults with depressive symptoms may participate in religious activities which may reduce their chances of cognitive impairment. This protective effect of religiosity and religious participation on late life cognitive health has important implications for promoting alternative social support mechanisms for older adults in terms of enhancing their mental wellbeing and contributing to active aging.

Assessing the role of depressive symptoms in the association between social engagement and cognitive functioning among older adults: analysis of cross-sectional data from the Longitudinal Aging Study in India (LASI)

“…In contrast, studies on cognitive abilities in developing countries find older women often perform worse than older men 87 88. Moreover, earlier studies in India reported a relatively lower cognitive functioning level among older women than men 46–48 89. In line with the previous literature, the current findings suggest a significant female disadvantage in cognitive function among older Indian adults and call for special attention with regard to public policy frameworks, clinical practice and future research.…”

Decomposition of caste differential in life satisfaction among older adults in India

“…Several studies have also documented a higher level of life satisfaction among religious people than non-religious individuals [ 56 ]. Thus, alternative social support mechanisms such as religious participation can be promoted in terms of enhancing mental wellbeing among older Indian adults [ 57 ]. Furthermore, the study has found that living arrangement satisfaction plays an important role in determining life satisfaction in older age.…”

Longitudinal association of spirituality with depressive symptom trajectories among older adults in mainland China

“…Third, the comfort and peace caused by spiritual beliefs and practices may reduce feelings of anxiety and depression, as well as improve mood, promote optimism and increase self-esteem. 41 Finally, greater importance of spirituality or religion in life may help to prevent depression by increasing cortical thickness or preventing cortical thinning. 42,43 This present study also found that age ≥65 years old, being female, hypertension and severe medical comorbidity were risk factors for the development of depressive symptoms.…”

“…Second, religious involvement as a form of social interaction may enhance social networks, and in this way have a positive impact on mental health. Third, the comfort and peace caused by spiritual beliefs and practices may reduce feelings of anxiety and depression, as well as improve mood, promote optimism and increase self‐esteem 41 . Finally, greater importance of spirituality or religion in life may help to prevent depression by increasing cortical thickness or preventing cortical thinning 42,43 …”